Citation Nr: 18160477
Decision Date: 12/26/18	Archive Date: 12/26/18

DOCKET NO. 03-12 995
DATE:	December 26, 2018
REMANDED
Entitlement to service connection for chalazion of the left eye, as secondary to service-connected sickle cell retinopathy, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1979 to June 1997.
This matter is before the Board of Veterans' Appeals (Board) on appeal of a December 2000 rating decision by the Atlanta, Georgia Department of Veterans Affairs (VA) Regional Office (RO).
In December 2003, the Veteran appeared at a hearing before a Veterans Law Judge, who has since retired from the Board.  Pursuant to 38 C.F.R. § 20.707, the Veteran was afforded a new hearing, which was held in July 2012 before the undersigned Veterans Law Judge.  Transcripts of the hearings are in the Veteran’s file.  
In June 2004, June 2009, June 2013, September 2014, and April 2016, the Board remanded the case to the RO for additional development.  
In an August 2017 decision, in pertinent part, the Board denied entitlement to service connection for chalazion of the left eye, including as secondary to service-connected sickle cell retinopathy.  
The appellant appealed to the U.S. Court of Appeals for Veterans Claims (Court).  In an Order dated in June 2018, pursuant to a June 2018 Joint Motion for Partial Remand (Joint Motion), the Court vacated the Board’s August 2017 decision as to the issue of entitlement to service connection for chalazion of the left eye as secondary to service-connected sickle cell retinopathy and remanded the issue to the Board.  
As will be explained below, the Board observes that the Veteran does not dispute the adequacy of the VA examination reports relied upon by the August 2017 Board decision as to the matter of direct service connection for chalazion of the left eye.  Although the June 2018 Joint Motion vacated the issue of entitlement to service connection for chalazion of the left eye, including as secondary to service-connected sickle cell retinopathy, the Board observes that the Joint Motion does not dispute the Board’s finding that the Veteran’s chalazion was not incurred in or aggravated by the Veteran’s military service.  As such, the Board finds that the Veteran has effectively conceded that the Board’s August 2017 decision was correct as to this point and thus, the Board recharacterized the issue as stated below.
Entitlement to service connection for chalazion of the left eye, as secondary to service-connected sickle cell retinopathy is remanded.
The Board acknowledges that the Veteran was afforded a VA examination in connection with his claim of entitlement to service connection for chalazion of the left eye, including as secondary to service-connected sickle cell retinopathy, in July 2015.  A May 2016 VA addendum medical opinion was also obtained.  As indicated above, the Board observes that the Joint Motion explicitly states that the VA examination and addendum medical opinion were inadequate because the opinions did not address whether the Veteran’s chalazion of the left eye was aggravated by his service-connected sickle cell retinopathy.  To this point, the Board reiterates that the Joint Motion, and by extension, the Veteran, effectively concede that the Board’s decision as to the issue of entitlement to service connection for chalazion of the left eye was correct by finding that the VA medical opinions of record were only inadequate as to the issue of aggravation by a service-connected disability.
In accordance with the Joint Motion, the Board finds that VA must obtain an addendum medical opinion regarding the claim of entitlement to service connection for chalazion of the left eye, as secondary to service-connected sickle cell retinopathy.  Specifically, the medical opinion must address whether the Veteran’s chalazion of the left eye was aggravated by his service-connected sickle cell retinopathy.  See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate).  A probative medical opinion should be based on an accurate factual premise. Kowalski v. Nicholson, 19 Vet. App. 171 (2005).  VA cannot exercise independent medical judgment in deciding an appeal; thus, a new medical opinion must be obtained.  See Colvin v. Derwinski, 1 Vet. App. 171 (1991).  
The matter is REMANDED for the following action:
1.  The RO should obtain an opinion from an appropriate VA medical professional or an addendum opinion from the May 2016 VA examiner.  Specifically, the VA examiner must address whether it is at least as likely as not (50 percent probability or more) that the Veteran’s chalazion of the left eye has been caused or aggravated by any of the Veteran’s service-connected disabilities, including service-connected sickle cell retinopathy.  

The requested determination should consider the July 2015 and May 2016 VA examination reports and clinical evidence of record.  The VA examiner is advised that the Veteran is competent to report symptoms, treatment, events, and injuries in service, and that his reports must be taken into account, along with the other evidence of record, in formulating the requested opinion.  
Aggravation is defined as worsening beyond the natural progression of the disability.
A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided.

 
ROBERT C. SCHARNBERGER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Hallie E. Brokowsky, Counsel

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